Reinvention Intake Questionnaire Please answer the questions below. Submit your form no later than 48 hours before our session. Reinvention Intake Questionnaire ΔFirst Name Last Name Email Phone/Mobile What has your career path been to date? (e.g. industries, specialities, length of time working, any career breaks): What are the three biggest accomplishments of your career? (Be specific, i.e. 'won the Pulitzer Prize for my latest novel.') What are your top ten skills & talents? (include those you've used at work, personally, and what your friends tell you you're good at): Do you have an idea for your reinvention goal? If so, list below: List five things you want MORE of in your life after your reinvention. Describe what each would look like (Example: "More time = The ability to leave work by 6pm every day and not work weekends."): List five things you want LESS of in your life after your reinvention. Describe what each would look like (Example: "Less travel = I take one or two trips per month, each no longer than three days."): Describe your current lifestyle around family, home, or anything else that must be accounted for in your reinvention: What are the top three barriers to your reinvention? What do you do for fun and relaxation? What do you think you need to change, or how do you need to grow, in order to execute your reinvention? What else is important to know for our work together? Finish and Submit
